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Inconclusive Pap Smear?

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The NCI researchers evaluated the value of HPV testing in nearly 2,200women with inconclusive Pap results identified as atypical squamous cells of undetermined significance (ASCUS) and another 848 women with low-grade squamous intraepithelial lesions (LSIL). Among women with LSIL, testing for HPV was not useful in identifying those who didn't need colposcopies. But among those with ASCUS, it was.

"We found that the test was equally sensitive for all ages, but the predictive value of the test -- the number of positive women who actually have the disease -- was much higher in older women," lead author Mark E. Sherman, MD, of NCI's Environmental Epidemiology Branch, tells WebMD.

"As people get older, their background infection level actually goes down," he says. "So when we do see the infection it may mean more. We know that most women who test positive for HPV do not have cervical cancer, but that may be especially true for younger women."

The American Medical Women's Association is the first major health organization to weigh in on the subject of HPV testing in cervical cancer screening, but it will not be the last. Long-awaited guidelines from leading medical organizations are due to be made public within the next few months.

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